Available online at www.sciencedirect.com Medical Engineering & Physics 30 (2008) 1387–1398 A perspective on intelligent devices and environments in medical rehabilitation  Rory A. Cooper a,b,* , Brad E. Dicianno a,b,c , Bambi Brewer a,b , Edmund LoPresti b,d , Dan Ding a,b , Richard Simpson a,b,c , Garrett Grindle a,b , Hongwu Wang a,b a Human Engineering Research Laboratories, Department of Veterans Affairs, Rehabilitation Research and Development Service, VA Pittsburgh Healthcare System, United States b Departments of Rehabilitation Science & Technology, Bioengineering, and Physical Medicine & Rehabilitation, University of Pittsburgh, United States c Center for Assistive Technology, University of Pittsburgh Medical Center, United States d AT Sciences, Inc., United States Received 6 May 2008; received in revised form 24 September 2008; accepted 25 September 2008 Abstract Globally, the number of people older than 65 years is anticipated to double between 1997 and 2025, while at the same time the number of people with disabilities is growing at a similar rate, which makes technical advances and social policies critical to attain, prolong, and preserve quality of life. Recent advancements in technology, including computation, robotics, machine learning, communication, and miniaturization of sensors have been used primarily in manufacturing, military, space exploration, and entertainment. However, few efforts have been made to utilize these technologies to enhance the quality of life of people with disabilities. This article offers a perspective of future development in seven emerging areas: translation of research into clinical practice, pervasive assistive technology, cognitive assistive technologies, rehabilitation monitoring and coaching technologies, robotic assisted therapy, and personal mobility and manipulation technology. Published by Elsevier Ltd on behalf of IPEM Keywords: Rehabilitation; Intelligent systems; Machine learning; Physical impairment; Wheelchairs; Cognitive impairment 1. Introduction There is a large and growing segment of our world population—people with reduced functional capabilities due to aging or disability. The number and percentages of peo- ple in need of advanced assistive technology are increasing every year. About 60 million Americans have a disability that affects one or more of their major life activities [1]. Per- ceptive, cognitive, and musculoskeletal diseases that impair  Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. * Corresponding author at: Human Engineering Research Laboratories (151-R1), 7180 Highland Drive, VA Pittsburgh Healthcare System, Pitts- burgh, PA 15206, United States. Tel.: +1 412 365 4850; fax: +1 412 365 4858. E-mail address: rcooper@pitt.edu (R.A. Cooper). motor skills dramatically increase with age. A number of sub- populations are of particular interest. In 2030, over 20% of the U.S. population will be over 65 years of age, with one in two working adults serving as informal caregivers [1]. Glob- ally, the number of people older than 65 years is anticipated to double between 1997 and 2025. There is little debate that the 76 million American children born between 1945 and 1964 represent a cohort that is significant on account of its size [1]. Boomers account for about 39% of Americans over the age of 18 and 29% of the total population [1]. Adults with disabil- ities comprise approximately 21,455,000 of the 169,765,000 of working-age individuals in the US. However, only 30% of adults with disabilities are employed [2]. In Japan, the per- centage of people of the age of 65 is also on the rise and it is project that by 2030 that approximately 30% of the pop- ulation will be over 65 [3]. In Europe it is projected that by 2060 that 30% of the population will be over 65 [4]. As indi- viduals, families, communities, and a planet, we are facing 1350-4533/$ – see front matter. Published by Elsevier Ltd on behalf of IPEM doi:10.1016/j.medengphy.2008.09.003